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May 1990 * American Psychologist * 612

Adolescent Drug Use and Psychological Health

A Longitudinal Inquiry

Jonathan Shedler and Jack Block
University of California Berkeley

ABSTRACT: The relation between psychological characteristics and drug use was
investigated in subjects studied longitudinally, from preschool through age 18.
Adolescents who had engaged in some drug experimentation (primarily with marijuana) were
the best-adjusted in the sample. Adolescents who used drugs frequently were maladjusted,
showing a distinct personality syndrome marked by interpersonal alienation, poor impulse
control, and manifest emotional distress. Adolescents who, by age 18, had never
experimented with any drug were relatively anxious, emotionally constricted, and lacking
in social skills.

Psychological differences between frequent drug users, experimenters, and abstainers
could be traced to the earliest years of childhood and related to the quality of parenting
received. The findings indicate that (a) problem drug use is a symptom, not a cause, of
personal and social maladjustment, and (b) the meaning of drug use can be understood only
in the context of an individual's personality structure and developmental history. It is
suggested that current efforts at drug prevention are misguided to the extent that they
focus on symptoms, rather than on the psychological syndrome underlying drug abuse.

Drug abuse among young people is one of the greatest challenges of our time. Almost
daily, we are besieged by media reports of drug-related tragedy, of shootings in our
schools, gang warfare, and overdose-related deaths. Many see the drug problem as epidemic
(Robins, 1984). As an increasing share of society's resources is diverted toward coping
with the drug problem and its consequences, the need for sound, scientific information on
the factors contributing to drug use is urgent.

Considerable research has already been directed toward studying the causes and
correlates of drug use, and important recognitions have developed (for reviews, see Bush
& Iannotti, 1985; Cox, 1985; Hawkins, Lishner, & Catalano, 1985; Jessor, 1979;
Jones & Battjes, 1985; Kandel, 1980). Nevertheless, many studies to date have been
interpretively constrained by various research-design or empirical limitations.

Large-scale epidemiological studies (e.g., Jessor, Chase, & Donovan, 1980;
Johnston, O'Malley, & Bachmail, 1984, 1986; National Institute on Drug Abuse [NIDA],
1986) have provided much-needed information about the prevalence and patterns of drug Use,
about the demographics of drug users, and about certain psychosocial characteristics of
drug users. In general, however, these studies have been unable to provide the kind of in
depth, psychologically rich, clinically oriented information needed to inform
intervention efforts. And by their very nature, cross-sectional studies and panel studies
of relatively brief duration can offer only limited or confounded understandings of the
antecedents of drug use.

Recognizing the crucial importance of prospective inquiry into the psychological
antecedents of drug use, a number of longitudinal studies of adolescent development have
been undertaken and have deepened our understanding of the interplay of psychosocial
forces during adolescence (e.g., Brook, Gordon, & Whiteman, 1985; Brook, Whiteman,
Gordon. & Cohen, 1986; Jessor & Jessor, 1977, 1978; Smith & Fogg, 1978; see
Kandel, 1978, for a review). In general, however, these studies have also been
interpretively constrained because they have studied adolescents already well along in
years (subjects have rarely been younger than age 13) and because they have tended to
track these adolescents for no more than three or four years, from junior high school
into high school or from high school into college. Also, these studies have tended to
depend, perhaps too heavily, on self-administered, mailed, or impersonally offered
questionnaires.

To date, only two truly long-term investigations into the childhood antecedents
of drug use have appeared. The Woodlawn study of Kellam and his associates (Kellam,
Branch, Agrawal, & Ensminger, 1975; Kellam, Brown, Rubin, & Ensminger, 1983)
traced the development of a group of poor, Black, urban children beginning at ages 6 to 7.
In the Woodlawn study, Kellam et al. found that psychological characteristics assessed at
ages 6 to 7 foretold drug use at ages 16 to 17, a decade later. The longitudinal study
initiated by Jeanne and Jack Block (see J. H. Block & J. Block, 1980) followed a group
of San Francisco Bay area children from nursery school on and found numerous,
theoretically coherent relations between psychological characteristics assessed in
nursery school and subsequent drug use in early adolescence, at age 14 (Block, Block,
& Keyes, 1988). These studies converge in demonstrating the existence of important
psychological antecedents of drug use, antecedents dating to the earliest years of
childhood. Conjointly, they suggest that early psychological factors may be central to an
understanding of drug use, and they highlight the need for prospective research.

The present study further reports on the Block and Block sample, studied again in late
adolescence when the

subjects had reached age 18. This later age represents a different developmental era,
one in which the implications of drug use and nonuse can well take on psychological
significance different from the significance of drug use and nonuse in early adolescence.
The findings we report span 13 years, from preschool through age 18. By virtue of their
prospective nature, these data allow inferences about the antecedents of drug use that
cannot be made from retrospective, cross-sectional, or short-term panel studies.

Beyond the length of time spanned by the present investigation, the study differs from
previous studies in two important ways. In most empirical studies, psychological
descriptions are limited to a small number of variables that are selected by researchers
on a priori grounds. In the present study, psychological descriptions are, for all
practical purposes, comprehensive and open-ended. They are based on extensive
evaluations of participants by panels of psychologists, and they encompass the full range
of constructs subsumed by the California Adult Q-sort (CAQ; Block, 1961/1978) and the
California Child Q-sort (CCQ; J. Block & J. H. Block, 1980) personality assessment
instruments specifically designed to allow clinicians to provide in-depth, comprehensive
psychological descriptions. The intention was to gather information psychologically rich
enough to speak to clinical concerns and to inform intervention efforts.

The study also Differs from previous studies in its approach to data analysis. Previous
investigators have tended to assume (and test for) linear relations between level of drug
use and measures of psychosocial disturbance. In effect, such an approach assumes that
occasional experimentation with drugs is psychologically problematic, if not quite as
problematic as regular use, and that complete avoidance of drugs is psychologically
optimal.

However, the majority of young adults in the United States, nearly two thirds, have
experimented with marijuana at one time or another (Johnston et al., 1986; Johnston,
Bachman, & O'Malley, 1981 a, 1981 b; Miller et al., 1983; NIDA, 1986), and the vast
majority of these young people do not subsequently become drug abusers. Little is
known about the relative psychosocial adjustment of adolescents who have experimented with
drugs on an occasional basis and of adolescents who have avoided drugs entirely. Indeed, a
number of researchers have suggested that occasional drug use among adolescents may be
best understood as a manifestation of developmentally appropriate experimentation.
Newcomb and Bentler (1988), for example, have observed that one defining feature of
adolescence is a quest for or establishment of independence and autonomous identity and
functioning. This may involve experimentation with a wide range of behaviors, attitudes,
and activities before choosing a direction and way of life to call one's own. This
process of testing attitudes and behavior may include drug use. In fact, experimental use
of various drugs, both licit and illicit, may be considered a normative behavior among
United States teenagers in terms of prevalence, and from a developmental task perspective.
(p. 214, emphasis added)

These empirical and developmental considerations suggest that the relations between
psychological variables and level of drug use may not be linear at all. To the extent that
drug experimentation may represent normative behavior during the prolonged adolescent
period, as individuals seek a sense of self and possibility, it may be wrong to
pathologize adolescents who experiment with drugs by assuming that they fall between
nonusers and drug abusers on a continuum of psychosocial adjustment. To evaluate this
conceptual possibility in the present study, we identify and contrast discrete groups of
nonusers, experimenters, and frequent drug users. Additionally, we employ quadratic
regression methods to formally test for curvilinear relations, when the data indicate that
such relations may exist. These approaches permit the emergence of findings not
discernible through conventional correlational methods with their assumption of linearity.

Method

Subjects

Subjects were 101 18-year-olds, 49 boys and 52 girls, from an initial sample of 130
participating in a longitudinal study of ego and cognitive development. The subjects were
initially recruited into the study at age 3, while attending either a university-run
nursery school or a parent cooperative nursery school in the San Francisco Bay area. They
were assessed on wide-ranging batteries of psychological measures at ages 3, 4, 5, 7, 11,
14, and 18 (see J. H. Block & J. Block, 1980, for an extended description of the
study). Because so few subjects were lost over the years, there can be little influence of
differential attrition.

The subjects live primarily in urban settings and are heterogeneous with respect to
social class and parent education. About two thirds are White, one fourth are Black, and
one twelfth are Asian. Not all subjects are used in all analyses to be reported, as will
be discussed.

Measuring Drug Use

Information about drug use was collected at age 18 during individual interviews with
the subjects. Skilled clinicians conducted these interviews, which ranged over a variety
of topics including schoolwork, peer relations, family dynamics, personal interests,
dating experiences, and so on. Total interview time was typically four hours per subject,
and all interviews were videotaped.

The subjects were asked whether they "smoked pot or used it in another form."
Their responses were coded from the interview videotapes as follows: (0) never used
marijuana; (1) used once or twice; (2) used a few times; (3) used once a month; (4) used
once a week; (5) used two or three times a week; and (6) used daily. The subjects

________________________
footnote:The study was supported by National Institute of Mental Health Grant MH
16080 to Jack and Jeanne H. Block.

Correspondence concerning this article should be addressed to Jonathan Shedler or Jack
Block, Department of Psychology, University of California, Berkeley, CA 94720.
________________________

May 1990 * American Psychologist * 614

were also given a list of other substances and were asked to check which (if any) they
had used at least once on a "recreational" basis. The list included inhalants
(e.g., glue, nitrous oxide), cocaine, hallucinogens, barbiturates, amphetamines,
tranquilizers, heroin, and an open-ended category for "other" drugs not
specifically listed.

Although self-report data on drug use are always subject to underreporting, the
findings of a number of investigations indicate that such data have high validity (e.g.,
Block et al., 1988; Haberman, Josephson, Zanes, & Elinson, 1972; Jessor & Jessor,
1977; Perry, Killen, & Slinkard, 1980; Single, KandeI, & Johnston, 1975).
Additionally, there is every reason to believe that the subjects in this investigation
answered our questions honestly. The interviewers were skilled in gaining rapport and in
eliciting information without inducing discomfort. Moreover, the subjects had been
involved in the longitudinal study from earliest childhood; they not only had been assured
that their individual responses would be held in confidence, but they knew from years of
prior experience that this promise had been honored.

Measuring Personality

Age 18 assessment. At age 18, the personality characteristics of each subject
were described by four psychologists, using the standard vocabulary of the California
Adult Q-sort (Block, 1961/1978). The CAQ is a personality assessment instrument that
allows psychologists to provide comprehensive personality descriptions in a conceptually
systematic, quantifiable, and readily comparable form. The CAQ consists of 100
personality-descriptive statements, each printed on a separate index card. The
psychologist sorts these statements into a fixed nine-step distribution, according to
their evaluated salience vis-a-vis the person being described. Thus, the CAQ yields a
score of 1 through 9 for each of 100 personality-descriptive statements; higher scores
indicate that a statement is relatively characteristic of a person, and lower scores
indicate that it is relatively uncharacteristic. The validity and usefulness of Q-sort
personality descriptions has been demonstrated frequently (see, e.g., Bem & Funder,
1978; Block, 1961/1978; Block, 1971; Gjerde, Block, & Block, 1988; Mischel, Shoda,
& Peake, 1988). 1

The psychologists based their CAQ descriptions of each subject on observations made
while administering a variety of experimental procedures designed to tap various aspects
of psychological functioning. These psychologists were not the interviewers who
gathered information about drug use; they had no knowledge of subjects' drug use or of any
other information elicited during the interviews. Each of the four psychologists who
provided CAQ-based personality descriptions saw the subjects in a different assessment
context, so that four entirely independent Q-sort descriptions were available per
subject. The scores assigned to each Q sort item were then averaged across the four
psychologists, to yield a final, composite Q-sort for each subject. These composite
Q-sorts thus represent the consensual judgment of four independent assessors. The
reliabilities of the composite Q-sorts differed somewhat from subject to subject, and were
of the order of .70 to .90.

Childhood assessments. At ages 7 and 11, the personality characteristics of the
subjects were described in a similar manner, each time by entirely different sets of
psychologists, using the standard vocabulary of the California Child Q-sort (CCQ). The CCQ
is an age-appropriate modification of the California Adult Q-sort, and consists of
statements describing the personality, cognitive, and social characteristics of children
(see J. Block & J. H. Block, 1980; J. H. Block and J. Block, 1980). At age 7, the
standard 100-item CCQ was used; at age 11, an abridged 63-item version was used. Three
psychologists observed the children at age 7, and five psychologists observed the children
at age 11, while administering a variety of age appropriate experimental procedures. The
scores assigned to the CCQ items were averaged across the psychologists to produce a
composite Q sort for age 7 and a composite Q-sort for age 11. Again, the reliabilities of
the composite Q-sorts were of the order of .70 to .90.

Measuring the Quality of Parenting

When the subjects were five years old they participated in a joint assessment session with
their mothers and in a separate joint assessment session with their fathers. The purpose
of the joint sessions was to allow observations of parent-child interactions under
standard conditions.

During each joint assessment session, the children were given a variety of
age-appropriate tasks to perform, such as assembling objects from wooden blocks, arranging
plastic pieces according to shape and color, solving mazes, and so on. The parents were
instructed to respond to their child's eventual difficulties with the tasks and to provide
whatever help they felt was needed. The tasks were designed to be of interest to parent
and child, to be appropriately challenging to the child, and to be readily understandable
to all parents. The order of the sessions and the order of tasks within sessions were
counterbalanced. The joint assessment procedure has been described in more detail
elsewhere (Block & Block, 1971; Gjerde, 1988).

Parent and child were left alone to work on the tasks while a trained observer watched
the interaction through a one-way mirror. Additionally, the sessions were videotaped.
After the session, the observer described the parent's manner of interacting with the
child using a 49-item Parent Child Interaction Q-sort (PCIQ) specially developed for this
purpose (Block & Block, 1971). A second observer provided

________________________1. The specific personality-descriptive statements that make up the
California Adult Q-Sort are the result of a lengthy selection process, aimed at developing
an item set of sufficient richness to allow a comprehensive description of an individual's
psychological functioning. Experienced clinicians employed an initial set of descriptive
statements to describe a variety of individuals, including psychiatric cases, they knew
well. In the process, important item omissions were revealed, ambiguities of wording
noted, and redundancies recognized. Needed items were then added, ambiguities clarified,
and redundancies eliminated. This process iterated through a number of cycles until the
item set was deemed sufficiently comprehensive to do justice to the clinical
psychologists' formulations. A detailed description of the development of the California
Adult Q-Sort is found in Block (1961/1978).
________________________

May 1990 * American Psychologist * 615

an additional Q-sort description after watching the session on videotape. The two Q-sorts
describing the mother-child interaction were composited, as were the two Q-sorts
describing the father-child interaction.

Results

Rates of Drug Use

The primary purpose of this study was to investigate the relations between drug use and
psychological characteristics. However, it is first useful to consider the rate of drug
use in the sample in absolute terms.

Of the 101 subjects for whom information about drug use was available, 68% had tried
marijuana (four years earlier, 51% of the subjects had used marijuana; see Keyes &
Block, 1984). Thirty-nine percent of the subjects reported using marijuana once a month or
more, and 21% reported using it weekly or more than weekly. These figures are comparable
to figures obtained in nationwide probability samples of adolescents and young adults
(Johnston et al., 1986; Johnston, Bachman & O'Malley, 1981 a, 1981 b; Miller et al.,
1983; NIDA, 1986).

Approximately 37% of the subjects reported trying cocaine, and 25% reported trying
hallucinogens. Approximately 10% of the subjects reported trying amphetamines,
barbiturates, tranquilizers, or inhalants. Only one subject reported that she had used
heroin.

Creation of Comparison Groups

Based on the drug use information collected at age 18, the subjects were divided into
three nonoverlapping groups, as follows.

Abstainers were defined as subjects who had never tried marijuana or any other
drug. This group contained 29 subjects, 14 boys and 15 girls. 2

Experimenters were defined as subjects who had used marijuana "once or
twice," "a few times," or "once a month," and who had tried no
more than one drug other than marijuana. This group contained 36 subjects, 16 boys and 20
girls. The mean number of other drugs tried by the subjects in this group was 0.31
(i.e., 11 of the 36 subjects had tried one drug other than marijuana).

Frequent users were defined as subjects who reported using marijuana frequently,
that is, once a week or more, and who had tried at least one drug other than marijuana.
This group contained 20 subjects, 11 boys and 9 girls. The mean number of other drugs
tried by the subjects in this group was 2.70. 3

Sixteen subjects "fell between the cracks" of the classification scheme, and
did not meet the definitional criteria for any of the groups. In general, these were
subjects who were excluded from the abstainer and experimenter groups because of their use
of drugs other than marijuana.

The basis for the groupings derives from conceptual considerations, as well as from
some recognitions derived from prior evaluation of the subjects in early adolescence

(Block et al., 1988). Obviously, a degree of arbitrariness is unavoidable in any such
classification scheme; however, the results to be reported are robust with respect to the
various group definitions. That is, we considered both broader and narrower definitions
for the various groups (e.g., excluding from the group of experimenters subjects who had
tried any drug other than marijuana, or including subjects who had tried as many as two
other drugs). As long as the sample was divided into three groups that could be broadly
construed in terms of nonusers, experimenters, and regular users, the pattern of results
we report emerged reliably.

The groups were first compared on the control variables of socioeconomic status, as
assessed by both the Duncan (1961) and Warner, Meeker, and Eells (1949) indexes and IQ, as
measured by the Wechsler Preschool and Primary Scale of Intelligence (WPPSI) at age 4, the
Wechsler Intelligence Scale for Children (WISC) at age 11, and the Wechsler Adult
Intelligence Scale (WAIS) at age 18. No associations approaching significance were
observed; consequently, these variables cannot be readily invoked to explain subsequent
findings.

Personality Concomitants of Drug Use

The major findings from the age 18 personality assessment are presented in Table I,
which lists mean scores for the CAQ items differentiating between frequent drug users,
experimenters, and abstainers.

Findings are presented using the experimenters as a reference group, and the
personality characteristics associated with the other groups are elucidated through
comparison with them. The experimenters are used as a frame of reference for two reasons:
(a) they constitute the largest group and reflect the pattern of drug use most typical for
this sample and most typical for adolescents in the nation as a whole; (b) the group of
experimenters lies between the other groups on the continuum of frequency of drug use;
therefore, its use as a reference group facilitates the discernment of possible curvilinear relations between drug use and personality measures. As will be seen, this second
consideration takes on considerable importance.

Personality Characteristics of Frequent Users

The frequent users were compared with the experimenters on each of the 100 Q-sort
items, by means of separate tests. The number of statistically significant differences
between the groups is striking and far exceeds the number

________________________2. Although it would have been preferable to analyze the sexes separately
in order to either investigate sex differences or to cross-validate the relations
observed, the resulting small group sizes would have inordinately weakened the power of
statistical tests. Because there is an appreciable similarity of the sexes with respect to
the psychological correlates of drug use (e.g., Block et al., 1988; Jessor & Jessor,
1978; Newcomb & Bentler, 1988; Stein, Newcomb, & Bentler, 1986), the decision to
merge the sexes seemed warranted.

3. The most frequently mentioned drugs were cocaine, hallucinogens, and amphetamines,
which had been used by 81%, 67%, and 43% of the frequent users, respectively.
________________________

May 1990 * American Psychologist * 616

Table I
Mean Scores for Age 18 California Adult Q-sort (CAQ) Items

CAQ item

Abstainers

Experimenters

Frequent users

1. Is critical, skeptical, not easily impressed.

4.9

4 .6

5.6***

2. Is a genuinely dependable and responsible person.

7.7

7.5

5.9***

5. Behaves in a giving way with others.

6.4

6.5

5.5***

6. Is fastidious.

5.3**

4.9

4.2**

7. Favors conservative values in a variety of areas.

5.6**

5.0

3.6***

13. Thin-skinned; sensitive to anything that can be construed as
criticism.

The following set of Q-sort items, all of which discriminate beyond the .05 level,
serve to characterize the frequent users. The items are grouped according to general
conceptual similarity. Inspection of Table I will reveal additional items that supplement
this summary characterization.

Relative to experimenters, frequent users are described as not dependable or
responsible, not productive or able to get things done, guileful and deceitful,
opportunistic, unpredictable and changeable in attitudes and behavior, unable to delay
gratification, rebellious and nonconforming, prone to push and stretch limits, self -
indulgent, not ethically consistent, not having high aspirations, and prone to express
hostile feelings directly.

Relative to experimenters, frequent users are also described as critical, ungiving, not
sympathetic or considerate, not liked and accepted by others, not having warmth or the
capacity for close relationships, having

________________________4. "The number of statistically significant findings and the
theoretical coherence of these findings leaves little doubt that the observed differences
between groups are both reliable and robust. The reader is cautioned, however, not to
overemphasize the statistical "significance" or lack of significance of any
single statistical test. The use of the .05 level as a threshold for determining
significance is always arbitrary. Moreover, given the sheer number of t-tests
computed, there may be instances of both Type I and Type II errors.________________________

hostility toward others, prone to avoid close relationships, distrustful of people, not
gregarious, not personally charming, and not socially at ease.

Finally, frequent users are described as relatively overreactive to minor frustrations,
likely to think and associate to ideas in unusual ways, having brittle ego-defense
systems, self-defeating, concerned about the adequacy of their bodily functioning,
concerned about their adequacy as persons, prone to project their feelings and motives
onto others, feeling cheated and victimized by life, and having fluctuating moods.

Consistent with the CAQ descriptions suggesting alienation and poor impulse control,
the frequent users attain significantly lower high school grade point averages than the
experimenters, 2.3 versus 3.0 (p

When the Q-sort descriptions are considered as a set, the picture of the frequent
user that emerges is one of a troubled adolescent, an adolescent who is interpersonally
alienated, emotionally withdrawn, and manifestly unhappy, and who expresses his or her
maladjustment through undercontrolled, overtly antisocial behavior.

Personality Characteristics of Abstainers

The abstainers were compared with the experimenters on each of the 100 Q-sort items, by
means of separate t-tests. Once again, the number of statistically significant CAQ
items well exceeds chance, with 19 of the 100 CAQ items showing differences between the
groups at the .05 level.

The following Q-sort items, all significant beyond the .05 level, serve to characterize
the abstainers.

May 1990 * American Psychologist * 618

Relative to experimenters, abstainers are described as fastidious, conservative, proud of
being "objective" and rational, overcontrolled and prone to delay gratification
unnecessarily, not liked or accepted by people, moralistic, unexpressive, prone to avoid
close interpersonal relationships, predictable in attitudes and behavior, not gregarious,
not able to enjoy sensuous experiences, basically anxious, not straightforward and
forthright with others, not physically attractive, not personally charming, and not
socially at ease.

The abstainers and the experimenters achieve identical high school Grade Point
Averages, 3.0 in both cases.

When the Q-sort items are considered as a set, the picture of the abstainer that
emerges is of a relatively tense, overcontrolled, emotionally constricted individual who
is somewhat socially isolated and lacking in interpersonal skills.

Personality Antecedents of Drug Use

An unusual feature of the present study is that psychological descriptions of subjects
are available from early childhood on. Moreover, the psychological descriptions obtained
at different ages are wholly independent of one another. We wish to emphasize this
independence: The psychologists who saw the subjects at different ages were different
people, they saw the subjects under different conditions, they saw the subjects only at
the age at which they served as assessors, and they had no contact with one another.
Because of the safeguards taken to ensure the independence of the data, relations between
psychological characteristics observed at age 18 and psychological characteristics
observed in early childhood must be attributed to continuities in psychological
development over time (and not to artifacts of the research design).

On the basis of the CAQ descriptions obtained at age 18, a priori directional
hypotheses were generated for virtually all of the age 11 and age 7 California Child
Q-Sort items. Specifically, it was hypothesized that abstainers would show signs of
impulse overcontrol, and frequent users would show signs of impulse undercontrol, relative
to experimenters; and that abstainers and frequent users would both show signs of
interpersonal alienation and psychological distress, relative to experimenters. 5 In view
of the existence of directional hypotheses and the independence of the data collected at
different ages, one-tailed statistical tests were employed in evaluating the childhood CCQ
data. Table 2 lists the mean scores for the age 11 CCQ items discriminating between the
groups (recall that an abridged 63-item Q-sort was used at the age 11 assessment, so fewer
significant relationships can be expected), and Table 3 lists the mean scores for the age
7 CCQ items discriminating between groups.

The Childhood Personality of Frequent Users

The frequent users were compared with the experimenters on each of the CCQ items by
means of separate t-tests. At age 11, frequent users were described (in comparison
to experimenters) as visibly deviant from their peers, emotionally labile, inattentive and
unable to concentrate, not involved in what they do, stubborn (preceding items significant at the .05 level),
unhelpful and uncooperative, pushing and stretching limits, not eager to please,
immobilized under stress, not curious and open to new experience, likely to give up
easily, likely to withdraw under stress, not having high performance standards, suspicious
and distrustful, and overreactive to minor frustrations (preceding items significant at
the .10 level).

At age 7, the frequent users were described as not getting along well with other
children, not showing concern for moral issues (e.g., reciprocity, fairness), having
bodily symptoms from stress, tending to be indecisive and vacillating, not planful or
likely to think ahead, not trustworthy or dependable, not able to admit to negative
feelings, not self-reliant or confident (preceding items significant at the .05 level),
preferring nonverbal methods of communication, not developing genuine and close
relationships, not proud of their accomplishments, not vital or energetic or lively, not
curious and open to new experience, not able to recoup after stress, afraid of being
deprived, appearing to feel unworthy and "bad," not likely to identify with
admired adults, inappropriate in emotive behavior, and easily victimized and scapegoated
by other children (preceding items significant at the .10 level).

In short, the frequent users appear to be relatively maladjusted as children. As
early as age 7, the picture that emerges is of a child unable to form good relationships,
who is insecure, and who shows numerous signs of emotional distress. These data indicate
that the relative social and psychological maladjustment of the frequent users predates
adolescence, and predates initiation of drug use.

The Childhood Personality of Abstainers

The abstainers were compared with the experimenters on each of the CCQ items. At age
11, the abstainers were described as relatively fearful and anxious, using and responding
to reason, not physically active, not vital or energetic or lively, inhibited and
constricted, not liking to compete, not curious and open to new experiences, not
interesting or arresting, physically cautious, neat and orderly (implies fussiness),
anxious in unpredictable environments, not having a rapid personal tempo, looking to
adults for help and direction, not responsive to humor, not self-assertive, not
self-reliant or confident, shy and reserved (preceding items significant at the .05
level), cold and unresponsive, immobilized under stress, obedient and compliant, not calm
or relaxed, planful and likely to think

________________________5. These hypotheses are based on conceptual considerations as
well as on results of factor analytic examination of the age 18 CAQ data. See the section
entitled Underlying Personality Factors: Linear and Curvilinear Relationships.

6. The use of one-tailed tests may seem insufficiently
conservative to Some. However, the thrust of the findings would be the same regardless of
whether one- or two-tailed statistical tests were employed. Moreover, there is an inherent
trade-off between the level of Type I and Type II errors. Given an exploratory study
involving difficult-to-obtain data, it seems scientifically strategic to lessen the likelihood of Type II errors, rather than to overprotect against Type I errors (cf. Block,
1960).

________________________

May 1990 * American Psychologist * 619

Table 2
Mean Scores for Age 11 California Child Q-sort (CCQ) Items

CQ item

Abstainers

Experimenters

Frequent users

1 . Prefers nonverbal methods of communication.

4.6

4.5

5.1*

3. Is warm and responsive.

5.3**

6.2

5.2**

6. Is helpful and cooperative.

7.0

7.2

6.5**

8. Tends to keep thoughts, feelings, or products to self.

5.6*

4.7

5.3

13. Characteristically pushes and tries to stretch limits.

3.0*

3.6

4.2

14. Is eager to please.

6.0

6.1

5.3**

21. Tries to be the center of attention.

3.1**

3.8

3.9

23. Is fearful and anxious.

4.5***

3.3

4.0

25. Uses and responds to reason.

7.3**

6.6

6.5

26. Is physically active.

5.2**

5.9

5.7

27. Is visibly deviant from peers in physical appearance.

3.3

3.0

3.7**

28. Is vital, energetic, lively.

4.9**

5.9

5.2

30. Tends to arouse liking and acceptance in adults.

6.1

6.5

5.9*

34. Is restless and fidgety.

3.7***

4.6

5.1

35. Is inhibited and constricted.

5.1**

3.9

4.4

37. Likes to compete; tests and compares self with others.

4.1**

4.5

4.6

39. Becomes rigidly repetitive or immobilized under stress.

4.2*

3.5

4.2*

40. Is curious, eager to learn, open to new experiences.

5.4***

6.4

5.7*

41. Is persistent in activities; does not give up easily.

5.9

5.6

5.1*

42. Is an interesting, arresting child.

5.1**

5.8

5.1*

45. Tends to withdraw and disengage when under stress.

5.0*

4.2

5.2**

47. Has high standards of performance for self.

6.1

5.9

5.1**

52. Is physically cautious.

5.1***

4.0

4.5

54. Has rapid shifts in mood; is emotionally labile.

3.5

3.4

4.2**

59. Is neat and orderly in dress and behavior.

6.5***

5.5

5.2

60. Becomes anxious in unpredictable environment.

4.9**

4.0

4.8*

62. Is obedient and compliant.

6.5*

5.8

5.6

63. Has a rapid personal tempo; reacts and moves quickly.

4.2**

5.0

4.6

64. Is calm and relaxed, easy-going.

5.0*

5.6

5.2

66. Is attentive and able to concentrate.

7.0

6.6

5.9

67. Is planful; thinks ahead.

6.9**

6.1

5.9

71. Looks to adults for help and direction.

5.6

5.0

4.6

73. Responds to humor.

4.9**

5.7

5.7

74. Becomes strongly involved in what she or he does.

5.8

6.2

5.2**

75. Is cheerful (low placement implies unhappiness).

5.4**

6.3

5.6

79. Tends to be suspicious and distrustful of others.

3.8**

2.9

3.8**

82. Is self-assertive.

4.4**

5.3

5.2

84. Is a talkative child.

4.6*

5.4

4.6*

85. Is aggressive (physically or verbally).

2.9*

3.4

3.8

88 Is self-reliant, confident, trusts-own judgment.

5.4*

5.9

5.8

90. Is stubborn.

4.3

4.0

4.8**

94. Tends to be sulky or whiny.

3.7

3.1

4.0**

95. Overreacts to minor frustrations; is easily irritated.

3.5

3.1

3.9**

98. Is shy and reserved; makes social contacts slowly.

5.6**

4.3

5.0

99. Is reflective; deliberates before speaking or acting.

6.7*

6.0

6.1

* Differs from experimenters, p

ahead, not cheerful, not talkative, and not aggressive (preceding items significant at the
.10 level).

At age 7, the abstainers were described as relatively eager to please, inhibited and
constricted, conventional in thought, neat and orderly, planful and likely to think ahead,
not verbally expressive, not seeking to be independent and autonomous (preceding items
significant at the .05 level), not proud of their accomplishments, not physically active,
immobilized under stress, obedient and compliant, not self-assertive, not competent and
skillful, and not creative (preceding items significant at the .10 level).

These descriptions present a picture of a child who is relatively overcontrolled,
timid, fearful, and morose.

May 1990 * American Psychologist * 620

Table 3
Mean Scores for Age 7 California Child Q-sort (CCQ) Items

CCQ item

Abstainers

Experimenters

Frequent users

1. Prefers nonverbal methods of communication.

4.6*

4.4

4.7**

3. Is warm and responsive.

5.6

5.7

5.5*

4. Gets along well with other children.

6.1

5.8

5.3**

5. Is admired and sought out by other children.

5.1

5.2

4.8*

7. Seeks physical contact with others (touching, hugging, etc.).

4.9

4.9

4.6*

8. Tends to keep thoughts, feelings, or products to self.

5.0*

4.7

5.1*

14. Is eager to please.

5.6*

5.4

5.3

15. Shows concern for moral issues (fairness, reciprocity).

5.4

5.5

5.1*

16. Tends to be pleased with his/her accomplishments.

5.6*

5.8

5.6*

20. Tries to take advantage of others.

4.1**

3.8

4.0

23. Is fearful and anxious.

4.5

4.3

4.5*

26. Is physically active.

5.4*

5.6

5.5

28. Is vital, energetic, lively.

5.6

5.7

5.3**

32. Tends to give, lend, and share.

5.7*

5.4

5.2

34. Is restless and fidgety.

4.5*

4.8

4.8

35. Is inhibited and constricted.

4.6**

4.3

4.6

38. Has unusual thought processes.

4.6***

5.2

5.2

39. Becomes rigidly repetitive or immobilized under stress.

4.2*

4.0

4.3*

40. Is curious, eager to learn, open to new experiences.

5.5

5.6

5.4*

43. Can recoup or recover after stressful experience.

5.3

5.2

5.0*

44. When in conflict with others, yields and gives in.

4.7

4.5

4.9**

45. Tends to withdraw and disengage when under stress.

4.6

4.5

4.8*

50. Has bodily symptoms as a function of stress.

4.2

4.2

4.9***

53. Tends to be indecisive and vacillating.

4.3

4.3

4.6**

55. Is afraid of being deprived.

4.4

4.2

4.5*

59. Is neat and orderly in dress and behavior.

5.7

5.2

5.2

62. Is obedient and compliant.

5.6*

5.3

5.4

67. Is planful; thinks ahead.

5.1

5.4

5.1**

69. Is verbally fluent; can express ideas well.

5.2***

5.7

5.5*

72. Has a readiness to feel guilty; puts blame on self.

4.1**

4.5

4.4

76. Can be trusted; is dependable.

6.1

6.1

5.7*

77. Appears to feel unworthy; thinks of self as ''bad.''

4.0

4.0

4.5**

81. Can admit to own negative feelings.

5.1

5.0

4.5

83. Seeks to be independent and autonomous.

5.1

5.4

5.2

84. Is a talkative child.

5.1

5.3

5.0*

86. Likes to be by him/herself, enjoys solitary activities.

4.8

4.6

5.1**

87. Tends to imitate characteristics of those admired.

4.8

4.9

4.5**

88. Is self-reliant, confident; trusts own judgment.

5.4

5.5

5.3*

89. Is competent, skillful.

5.6*

5.9

5.7

91. Is inappropriate in emotive behavior.

4.1

4.4

4.8**

92. Is physically attractive, good-looking.

5.9***

5.5

5.7

96. Is creative in perception, work, thought, or play.

5.3*

5.5

5.3

97. Has an active fantasy life.

4.9

4.9

5.3*

100. Is easily victimized or scapegoated by other children.

4.1

4.1

4.6**

* Differs from experimenters, p

While the characterizations of these children as "anxious,"
"inhibited," and "immobilized under stress" are telling, more telling,
perhaps, may be the descriptions of what these children are not; relative to the reference
group of experimenters, they are not warm and responsive, not curious and open to new
experience, not active, not vital, and not cheerful.

Quality of Parenting

Table 4 lists the mean scores for the PCIQ items that discriminate between the mothers
of frequent users, experimenters, and abstainers. These data reflect direct observations
of mother-child interactions when the subjects were five years of age. Hypothesis tests
are two tailed.

Compared with the mothers of the experimenters, the mothers of the frequent users are
described as hostile, not spontaneous with their children, not responsive or sensitive to
their children's needs, critical of their children and rejecting of their ideas and
suggestions, not supportive and encouraging of their children, tending to dramatize their
teaching, making the test situation grim and distasteful rather than fun, pressuring their
children to work at the tasks, underprotective of their children, overly interested in and
concerned with their children's performance, conductingthe session in such a way that
their children do not enjoy it (preceding items significant at the .05 level), appearing
to lack pride in and be ashamed of their children, seeming to be confused about what is
expected of them in the test situation, conducting the session in unusual or atypical
ways, not giving their children praise, and not having a clear and coherent teaching style
(preceding items significant at the .10 level).

In brief the mothers of the frequent users are perceived as relatively cold,
unresponsive, and underprotective. They appear to give their children little
encouragement, while, conjointly, they are pressuring and overly interested in their
children's "performance. " The apparent net effect of this double-bind is that
they turn a potentially enjoyable interaction into a grim and unpleasant one.

Few items discriminated between the fathers of frequent users and the fathers of
experimenters.

Quality of Parenting: Abstainers

Compared with the mothers of the experimenters, the mothers of the abstainers were
described as hostile, not responsive or sensitive to their children's needs, critical of
their children and rejecting of their ideas and suggestions, frustrated by an inability to
find adequate strategies for teaching their children, not valuing their children's
originality, not supportive and encouraging of their children, overly interested in, and
concerned with, their children's performance, impatient with their children (preceding
items significant at the .05 level), appearing to lack pride in and be ashamed of their
children, seemingto be confused about what is expected of them in the test situation,
conducting the session in unusual or atypical ways, not giving their children praise, not
having a clear and coherent teaching style, pressuring their children to work at the
tasks, and conducting the session in such a way that their children do not enjoy it
(preceding items significant at the .10 level).

Like the mothers of the frequent users, these mothers are perceived as relatively
cold and unresponsive. They give their children little encouragement, while, conjointly,
they are pressuring and overly interested in their children's performance. Again, the
apparent net effect is that they make the interaction grim and unenjoyable.

A variety of PCIQ items discriminated between fathers of abstainers and fathers of
experimenters (these items are listed here and are not presented in a separate

May 1990 * American Psychologist * 622

table). Compared with the fathers of the experimenters, the fathers of
the abstainers were described as relatively attentive to the cognitive elements in the
test situation, not responsive or sensitive to their children's needs, not allowing open
disagreement between parent and child, maintaining tight control of the session, critical
of their children and rejecting of their ideas and suggestions, appearing to lack pride in
and be ashamed of their children, not encouraging their children to proceed independently,
not valuing their children's originality, using physical means (e.g., body language and
facial expression) to communicate with their children, overly interested in, and concerned
with, their children's performance, impatient with their children, conducting the session
in such a way that the children do not enjoy it, not deriving pleasure from being with
their children, intruding physically into their children's activities (preceding items
significant at the .05 level), setting too fast a pace for their children, seeming
confused about what is expected in the situation, not easy and relaxed, and pressuring
their children to work at the tasks (preceding items significant at the .10 level).

The picture that emerges is of an authoritarian and domineering father who squelches
spontaneity and creativity and who demands that things be done his way. He does not
appear to enjoy being with his child, and he ensures that his child does not enjoy being
with him.

Underlying Personality Factors: Linear and Curvilinear Relations

Up to this point, we have taken a person-centered approach in presenting our
findings. That is, we focused on discrete groups of subjects (e.g., frequent users) and
attempted to provide comprehensive and psychologically rich characterizations of these
subjects. Such a person centered approach is congruent with the orientation of clinical
practitioners and facilitates the often difficult task of translating empirical findings
into usable clinical insights.

The more common analytical approach is nomothetic or variable-centered. Such an
approach emphasizes variables rather than persons. In the context of the present
study, drug use is treated as a continuum, and the research inquiries become: "What
are the major personality variables associated with drug use?" and "What is the form
of the relations between these variables and drug use?"

Person-centered and variable-centered approaches can inform and complement one another,
each illuminating different facets of the problem at hand. The variable-centered analyses
that follow examine concomitant relations only (i.e., relations between drug use and
personality characteristics, both assessed at age 18).
Major Personality Dimensions

Impressionistic content analysis of the age 18 Q-sort items that discriminate between
frequent users, experimenters, and abstainers suggests that these items cluster around
three broad themes, having to do with (a) interpersonal relations, (b) subjectively
experienced emotional distress and (c) impulse regulation. To formally evaluate the
importance of these themes, the Q-sort items listed in Table I were subjected to factor
analysis (principle facto method). This factor analysis yielded three conceptually
interpretable factors after varimax rotation, which together accounted for 64% of the
variance in the Q-sort descriptions. The items that best mark the factors are listed in
Table 5. It can be seen from this table that the factors correspond to the three themes
identified here.

For each of the three factors, factor scales were constructed by averaging the relevant
CAQ items, after reversing the coding of items that were negative indicators of factors.
The alpha reliabilities were .96, .94, and .89 for the Quality of Interpersonal Relations,
Subjective Distress, and Ego-Control factors, respectively.7

Monotonic and Nonmonotonic Relations

Examination of the Q-sort findings presented in Table 1 reveals a mixture of monotonic
and nonmonotonic relations between personality characteristics and level of drug use.
Specifically, scores for certain CAQ items appear to increase (or decrease) monotonically
as a function of drug use, whereas scores for other CAQ items appear to manifest somewhat
"U"- (or inverted "U") shaped relations with drug use. The item
"Undercontrols needs and impulses; unable to delay gratification" (CAQ item 53)
illustrates a monotonic relation, with frequent users receiving higher scores than
experimenters, who in turn receive higher scores than abstainers. In contrast, the item
"Keeps people at a distance; avoids close interpersonal relationships" (CAQ item
48) illustrates a U-shaped relationship, with abstainers and frequent users both receiving
higher scores than experimenters.

The pattern of monotonic and nonmonotonic relations appears to be orderly.
Specifically, it appears that (a) items reflecting the Quality of Inter-personal Relations
factor show somewhat U- (or inverted U) shaped relations with level of drug use, such that
experimenters are judged to have healthier interpersonal relationships than either
abstainers or frequent users; (b) items reflecting the Subjective Distress factor manifest
somewhat U- (or inverted U) shaped relationship with level of drug use, such that
experimenters are judged to have a greater sense of emotional well-being than either
abstainers or frequent users; and (c) items reflecting the Ego-Control factor are related
monotonically to level of drug use, such that abstainers

________________________7. These alpha coefficients are somewhat inflated because they were
calculated from the same sample used to generate the factors.
________________________

are judged to be relatively overcontrolled with respect to impulse expression and
frequent users are judged to be relatively undercontrolled. Finally, the U-shaped
relations described here do not appear to be symmetric: Although both abstainers and
frequent users are evaluated relatively unfavorably in terms of the Quality of
Interpersonal Relations and Subjective Distress factors, it also appears that frequent
users are evaluated less favorably by far.

To test these observations formally, three separate hierarchical multiple regressions
were performed, in which level of marijuana use served as a predictor of the Quality of
Interpersonal Relations, Subjective Distress, and Ego-Control scales, respectively.8 Each regression equation included both a linear and a quadratic term.
The regressions were "hierarchical" in the sense that the linear term entered
the regression equation first, followed by the quadratic term, which provided a test of
curvilinearity. The regression analyses are based on the full sample of 101 subjects for
whom drug use and personality data were available; the previous distinctions between
abstainers, experimenters, and frequent users were ignored.

Table 6 presents the results of the three regression analyses. Both linear and
quadratic terms contributed significantly in the regression equation to predict Quality of
Interpersonal Relations, and in the regression equation to predict Subjective Distress
(i.e., the quadratic terms explained significant incremental variance, over and above the
variance explained by the linear terms). The significant contributions of the quadratic
terms indicate that these personality factors manifest, at least to some extent, U- or
inverted U-shaped relations with level of drug use. The quadratic term did not
significantly contribute to the regression equation to predict Ego-Control, indicating
that the relation between drug use and Ego-Control is essentially linear. Ego-Control is
quite strongly related to drug use (R = .52, p R = .33, p R = .29, pFigure 1 graphically illustrates the best-fit regression lines to predict Quality of
Interpersonal Relations, Subjective Distress, and Ego-Control. It can be seen that both
Quality of Interpersonal Relations and Subjective Distress show somewhat U- (or inverted
U) shaped relations with level of drug use (i.e., moderate experimentation with marijuana
is associated with more positive interpersonal relationships, and greater subjective
well-being, than either no marijuana use or heavy use). These U-shaped relations are
clearly asymmetric, with heavy marijuana

________________________8. Marijuana use is an ordinal variable (0 = never tried marijuana, 6 =
daily marijuana use; see Method section). Level of marijuana use is used as the predictor
variable in these regression analyses because it carries the most fine-grained information
regarding drug involvement and because it is the primary variable upon which
classification as abstainer, experimenter, or frequent user was based.
________________________

May 1990 * American Psychologist * 624

Table 6
Hierarchical Regressions of Three Personality Factors on Level of Marijuana Use

Personality factor

R

R 2

F

df

Increment In R 2

F*

Quality of Interpersonal Relations

Marijuana use: linear term

.22

.05

5.18*

1.98

linear term + quadratic term

.33

.11

5.92

2,97

.06

6.36**

Subjective Distress

Marijuana use: linear term

.21

.04

4.55*

1,98

linear term + quadratic term

.29

.09

4.58*

2,97

.04

4.6*

Ego Control

Marijuana use: linear term

.52

.27

36.67***

1,98

linear term + quadratic term

.52

.27

18.25***

2,97

.00

.15 ns

F value associated with increment In R 2. .PP

use associated with much greater intrapersonal and interpersonal disturbance than
abstention. It can also be seen from Figure 1 that the relation between drug use and
Ego-Control is linear: the more impulsivity, the greater the level of drug use.

General Discussion

Summary of Major Findings

On the basis of the drug use information collected at age 18, subjects were divided
into nonoverlapping groups made up of frequent drug users, experimenters, and abstainers.
At age 18, frequent users were observed to be alienated, deficient in impulse control, and
manifestly distressed, compared with experimenters. At age 18, abstainers were observed to
be anxious, emotionally constricted, and lacking in social skills, compared with
experimenters.

Differences between the groups were evident during childhood as well, at the age 7
and age 11 assessments. Consistent with the age 18 findings, frequent users were judged to
be relatively insecure, unable to form healthy relationships, and emotionally distressed
as children, compared with experimenters. Also consistent with the age 18 findings,
abstainers were judged to be relatively anxious, inhibited, and morose as children,
compared with experimenters.

Additionally, both frequent users and abstainers were judged to have received poorer
maternal parenting than experimenters, as assessed by direct observations of mother-child
interactions when the subjects were five years old. Compared with the mothers of
experimenters, both the mothers of frequent users and the mothers of abstainers were
perceived to be cold, critical, pressuring, and unresponsive to their children's' needs.

There were no noteworthy findings involving the fa-

May 1990 * American Psychologist * 625

thers of frequent users. However, fathers of abstainers were seen (in comparison with the
fathers of experimenters) as relatively unresponsive to their children's needs and as
authoritarian, autocratic, and domineering.

At age 18, the underlying personality factors relevant to an understanding of drug use
appear to be Quality of Interpersonal Relations, Subjective Distress, and Ego-Control.
When level of marijuana use is treated as a continuous variable, both the Quality of
Interpersonal Relations and the Subjective Distress factors show somewhat U-shaped
relationships with level of marijuana use. Ego-Control appears to be linearly related to
level of marijuana use, with heavy users showing the poorest impulse control.

On the Relation Between Drug Use and Psychological Health

When the psychological findings are considered as a set, it is difficult to escape the
inference that experimenters are the psychologically healthiest subjects, healthier than
either abstainers or frequent users. Psychological health is meant here in a global and
nonspecific sense, consistent with ordinary conversational usage, and consistent also with
empirical recognitions by mental health researchers that a general psychological
health/psychological distress factor underlies diverse clinical syndromes (e.g.,
Dohrenwend, Shrout, Egri, & Mendelsohn, 1980; Tanaka & Huba, 1984; Watson
& Clark, 1984). The inference that there is an inverted U-shaped relation between
level of drug use and psychological adjustment is supported by the patterns of Q-sort
items characterizing abstainers, experimenters, and frequent users, and also by the U-
(and inverted U) shaped relations observed between level of marijuana use and the two
personality factors, Quality of Interpersonal Relations and Subjective Distress.

The finding that frequent users are relatively maladjusted has been obtained by many
other investigators. The finding that abstainers also show some signs of relative
maladjustment (albeit of a very different kind) is, perhaps, unusual. In order to
understand this latter finding, we suggest it is important to consider both the meaning of
drug use within adolescent peer culture, as well as the psychology of adolescent
development.

First, it is necessary to recognize that in contemporary American culture, there is
wide prevalence and apparent acceptability of marijuana use in late adolescence. The
majority of the 18-year-olds in our sample approximately two thirds had tried marijuana at
one time or another. Such a high usage rate is consistent with the findings from national
probability samples (Johnston et al., 1986; Johnston, Bachman, & O'Malley, 1981a,
1981b; Miller et al., 1983; NIDA, 1986). Thus, some experimentation with marijuana cannot
be considered deviant behavior for high school seniors in this culture at this time. In a
statistical sense it is not trying marijuana that has become deviant.

Second, the extended period of adolescence is a time of transition, a time when young
people face the developmental task of differentiating themselves from parents and family
and forging independent identities. Experimenting with values and beliefs, exploring new
roles and identities, and testing limits and personal boundaries are normative behaviors
during adolescence, and they serve important developmental ends (cf. Erikson, 1968;
Havinghurst, 1972).

Given these factors---the ubiquity and apparent acceptability of marijuana in the peer
culture and the developmental appropriateness of experimentation and limit-testing during
adolescence---it is not surprising that by age 18, psychologically healthy, sociable, and
reasonably inquisitive individuals would have been tempted to try marijuana. We would not
expect these essentially normal and certainly normative adolescents to abuse the drug (and
it is crucial to distinguish between experimentation and abuse) because they would have
little need for drugs as an outlet for emotional distress or as a means of compensating
for lack of meaningful human relationships---but we should not be surprised if they try
it. Indeed, not to do so may reflect a degree of inhibition and social isolation in an
18-year-old.9

Although no prior study has focused explicitly on the psychology of adolescent
abstainers, there is some empirical precedent for the present finding that abstainers are
not the most well-adjusted of adolescents. Hogan, Mankin, Conway, and Fox (1970), using a
self-report personality inventory, compared marijuana users with nonusers in a college
population and found that users "are more socially skilled, have a broader range of
interests, are more adventuresome, and more concerned with the feelings of others"
(p. 63). Nonusers were characterized as "too deferential to external authority,
narrow in their interests, and overcontrolled" (p. 61). These findings, based on
entirely different methodology, are strikingly similar to our own. In a similar vein,
Bentler (1987) reported a small but reliable association between marijuana use and the
development of a positive self-concept.

We do not suggest that the inverted U-shaped relation between level of drug use and
psychological health expresses a fundamental psychological "principle" or
"law." Rather, we view this finding as a function of historical and social
circumstances-specifically, of the current prevalence of drug use in this culture,
conjoined with the developmentally appropriate propensity of adolescents to explore and
experiment. Gergen's (1973) arguments regarding "social psychology as history"
may be applicable here.

The U-shaped relations between psychological health and drug use are reminiscent of
U-shaped relations between psychological health and alcohol use noted in an earlier
generation of subjects. Thus, Jones (1968, 1971) found that moderate drinkers were
psychologically healthier than either problem drinkers or abstainers.

________________________9. In a previous report on the psychological correlates of drug use in
early adolescence (at age 14), the relations observed between drug use and psychological
factors were essentially monotonic, with drug users characterized by undercontrol and
alienation (Block et al., 1988). The curvilinear relations observed in the present study
were not fully discernible then, perhaps because issues of experimentation and identity
formation had not yet become paramount.
________________________

May 1990 * American Psychologist * 626

Moreover, the undercontrolled, alienated personality attributes of problem drinkers and
the overcontrolled, diffident personality attributes of alcohol abstainers were quite
similar to the personality attributes that characterize frequent drug users and drug
abstainers in the present study. Given the prevalence and apparent acceptability of
marijuana use among adolescents today, it would seem that marijuana use has taken on
psychological and sociological meanings for young people that, in earlier generations,
were associated with alcohol use.

Toward an Understanding of Frequent Drug Users

If drug use among experimenters reflects normative adolescent exploration and
inquisitiveness, it reflects something quite different in the group we have labeled
frequent users. Frequent users differ profoundly from the comparison group of
experimenters, and indications of their social and psychological maladjustment are
pervasive.

At age 18, the frequent users appear unable to invest in, or derive pleasure from,
meaningful personal relationships. Indeed, they seem fortified against the possibility of
such relationships through their hostility, distrust, and emotional withdrawal. Neither do
they appear to be capable of investing in school and work, or of channeling their energies
toward meaningful future goals. They are, then, alienated from the "love and
work" that lend a sense of satisfaction and meaning to life. Consistent with this,
they appear to feel troubled and inadequate. It is easy to see how these
characteristics could create a vicious cycle: Feeling troubled and inadequate, these
adolescents withdraw from work and relationships, and alienated from work and
relationships, they feel all the more troubled and inadequate.

Such a pattern of alienation can be expected to go hand in hand with an impaired
ability to control and regulate impulses. When there is little investment in either work
or relationships, that is, when there is little connection with those things that give
life a sense of stability and purpose, then the impulses of the moment become paramount.
The impulses are not adequately transformed or mediated by a broader system of values and
goals because such a system is lacking.

Shapiro (1965) has written eloquently on this point:

The normal person "tolerates" frustration or postpones the satisfaction of
his whim at least in part because he is also interested in other things; his heart is set
on goals and interests that are independent of the immediate frustration or extend beyond
the whim and supercede it in subjective significance. This is not simply a matter of
intellectual choice. Rather, the existence of these general goals and interests
automatically provides a perspective, a set of dimensions in which a passing whim or an
immediate frustration is experienced. In the absence of such goals and interests, the
immediately present frustration or the promised satisfaction must, accordingly, gain in
subjective significance, and under these conditions forbearance or tolerance is
unthinkable. (pp. 145-146)

Drugs would have a special appeal to the alienated and impulsive individuals we are
discussing. The temporary effects of various drugs "numb out" feelings of

isolation and inadequacy; they offer transient gratification to individuals who lack
deeper and more meaningful gratifications (i.e., through relationships and work); and
given the poor ability of these individuals to regulate impulse, the urge toward drug use
would meet with little inner resistance and would be little modified by a broader value
system.

The traits that characterize the frequent users can be seen, then, to form a
theoretically coherent syndrome, characterized by the psychological triad of alienation,
impulsivity, and subjective distress. The data indicate that the roots of this
syndrome predate adolescence and predate initiation of drug use.

As early as age 7, the frequent users show signs of the alienation, undercontrol, and
emotional distress that will characterize them at age 18. Relative to experimenters, they
are described as not getting along well with other children, as not developing genuine and
close relationships, as not showing concern for moral issues, as not trustworthy or
dependable, as having bodily symptoms from stress, as afraid of being deprived, as
appearing to feel unworthy, as inappropriate in emotive behavior, and so on (see Table 2).
The data clearly indicate, then, that the relative maladjustment of the frequent users
precedes the initiation of drug use.

This relative maladjustment perhaps may be traced, at least in part, to the maternal
parenting that the frequent users received, as assessed by direct observations of
mother-child interactions when the subjects were five years of age. Relative to the
mothers of experimenters, the mothers of frequent users were perceived as hostile,
critical and rejecting, and not sensitive or responsive to their children's needs.
Moreover, they seemed to place their children in a double-bind: Although they gave their
children little support and encouragement, they were simultaneously pressuring and overly
concerned with their children's "performance." 10

Toward an Understanding of Abstainers

Adolescents who have never experimented with marijuana or any other drug have not been
the subject of research attention, if only because their behavior does not pose an
obvious, confronting societal problem and because it has been presumed categorically that not
using drugs goes hand in hand with psychological health. However, our data suggest that,
relative to experimenters, abstainers in late adolescence are somewhat maladjusted.

________________________10. These findings do not necessarily imply that the emotional
difficulties of frequent drug users can be blamed on poor mothering. Such a view may in
part be correct, but it may also be too simplistic. As proponents of family therapy remind
us (e.g., Haley, 1976; Hoffman, 1981; Minuchin, 1974), it is difficult to speak of simple
causation when discussing a family system. If a mother is not sufficiently responsive to
her child's needs, it may be because an emotionally impoverished marital relationship does
not leave her with the emotional resources needed to invest in her child. In such a case,
causation could just as easily be said to lie with the father as with the mother. The
point here is that, given a pattern of reciprocal and circular causation within a
dysfunctional family system, a "causal" relationship might be found nearly
anywhere a researcher happened to look.
________________________

May 1990 * American Psychologist * 627

Unlike the patent, blatant maladjustment of frequent drug users, however, the
psychological inadequacies of abstainers are largely a private matter, limiting of life as
it is led, and do not attract societal attention. The constriction, uneasiness with
affect, and interpersonal deficiencies of abstainers are recognizable more by way of omission
than commission.

By omission, we refer to personal potentialities that seem to remain unfulfilled,
specifically, potentialities for emotional gratifications, friendship, and human warmth
and closeness. It is the relative capacity (or rather, incapacity ) to experience
these positive qualities of life that distinguishes abstainers from experimenters.
Relative to experimenters, the abstainers are described at age 18 as overcontrolled and
prone to delay gratification unnecessarily, not able to enjoy sensuous experiences, prone
to avoid close interpersonal relationships, not gregarious, not liked and accepted by
people, and so on. Thus, their avoidance of drugs seems less the result of "moral
fiber" or successful drug education than the result of relative alienation from their
peers and a characterological overcontrol of needs and impulses.

It seems likely that the relative overcontrol and emotional constriction of the
abstainers serves the psychological purpose of containing or masking feelings of
vulnerability. There is some evidence for this hypothesis in the age 18 personality
descriptions of our subjects, for the abstainers are described at this age as relatively
anxious. However, the strongest support for this hypothesis comes from the childhood data,
when the relative maladjustment of these subjects is most manifest. At age 11, for
example, prior to initiation of drug use, the abstainers are described (relative to
experimenters) as fearful and anxious, inhibited and constricted, immobilized under stress, anxious in unpredictable environments, not curious and open to new experience, not
vital or energetic or lively, not confident, not responsive to humor, and not cheerful.
These traits would appear to reflect a susceptibility to anxiety and, perhaps, a
consequent avoidance of circumstances or behaviors perceived as risky.

The hypothesis that emotional constriction serves the purpose of "containing"
feelings of vulnerability is reinforced further by observations of mother-child
interactions when the children were age five: The mothers of the abstainers were perceived
(relative to the mothers of the experimenters) as unresponsive, cold, critical, and
rejecting. Such parenting clearly has negative implications for psychological resiliency
and well-being. It is interesting that the descriptions of the mothers of abstainers are
strikingly similar to the descriptions of the mothers of the frequent users. These results
at least raise the possibility that the behavior of the abstainers and the behavior of
the frequent users, manifestly so different, represent alternative reactions to an
underlying psychological vulnerability.

The question of why abstainers and frequent users traveled such different developmental
pathways remains an open one. Character formation is a matter of complex temperamental and
developmental vicissitudes, and such questions have no straightforward answer. Our
findings suggest the speculation that the fathers of the abstainers; played a telling role
in their character development. They acted toward their children in ways that would seem
to increase anxiety, but their stern, authoritarian, and autocratic manner may have also
provided a model for dealing with that anxiety. It is conceivable that the children
internalized their fathers' attitudes, adopting an attitude toward their own impulses that
paralleled their father's attitudes toward them.

Implications for Theory and Social Policy

Taken as a whole, the present data indicate that drug use and drug abstinence have
theoretically coherent antecedents and must be understood within the context of an
individual's total psychology. Because experimenters and frequent users are,
psychologically, very different kinds of people, the meaning of drug use in these two
groups is very different. In the case of experimenters, drug use appears to reflect age
appropriate and developmentally understandable experimentation. In the case of frequent
users, drug use appears to be a manifestation of a more general pattern of maladjustment,
a pattern that appears to predate adolescence and predate initiation of drug use.
Undoubtedly, drug use exacerbates this earlier established pattern but, of course, the
logic of a longitudinal research design precludes invocation of drug use as causing this
personality syndrome.

The discovery of psychological antecedents predating drug use (see also Block et al.,
1988; Kellam et al., 1975; Kellam et al., 1983; Kellam, Ensminger, & Simon, 1980) can
to some extent be integrated with explanations of drug use that emphasize environmental
factors, once it is recognized that individuals, from early childhood, actively construct
and seek out environments that, given their essential personality, motivational, and
intellectual characteristics, they find particularly harmonious and vivifying (see, e.g.,
Scarr & McCartney, 1983). Rather than being passive recipients of
"environmental" influences, by the time of adolescence, individuals are
already appreciably formed psychologically and are actively evoking, actively seeking, and
actively forging the circumstances that will suit them and that will then, in an
adventitious way, "impinge" on them.

The recognition that problem drug use (and, for that matter, abstinence) has
developmental antecedents, that it is a part of a broad and theoretically coherent
psychological syndrome, and that it is not adequately explained in terms of peer influence
has important implications for social policy.

May 1990 * American Psychologist * 628

Current social policy seems to follow from the assumption that peer influence leads to
experimentation, which in turn leads to abuse. Thus, efforts at drug education are aimed
at discouraging experimentation by emphasizing the need to "just say no" to peer
influence. But adolescent experimentation in and of itself does not appear to be
personally or societally destructive (see also Kandel, Davies, Karus, & Yamaguchi,
1986, and Newcomb & Bentler, 1988), and peer influence does not appear to be an
adequate explanation for problem drug use. Moreover, given the developmental tasks
of the prolonged adolescent period, efforts aimed at eliminating adolescent
experimentation are likely to be costly and to meet with limited success.

Current efforts at drug "education" seem flawed on two counts. First, they
are alarmist, pathologizing normative adolescent experimentation and limit-testing, and
perhaps frightening parents and educators unnecessarily. Second, and of far greater
concern, they trivialize the factors underlying drug abuse, implicitly
denying their depth and pervasiveness. For so long as problem drug use is construed
primarily in terms of "lack of education," so long is attention diverted from
its disturbing psychological underpinnings: the psychological triad of alienation,
impulsivity, and distress. Paradoxically, then, the "just say no" approach may
be concerned with a "problem" that, from a developmental viewpoint, need not be
seen as alarming (adolescent experimentation), and it may be dismayingly oblivious to a
serious problem that is extremely alarming (the ubiquity of the psychological syndrome
that appears to underlie problem drug use).

The concept of drug "education" may have its current popular appeal in part
because the link between the problem (drugs) and the attempted solution (drug education)
is self-evident and thus reassures concerned parents, educators, and policymakers that
"something is being done." But educational approaches to drug prevention have
had limited success (Tobler, 1986), and society's limited resources might better be
invested in interventions focusing on the personality syndrome underlying problem drug
use.

Given current understandings of personality development, it would seem that the
psychological triad of alienation, impulsivity, and distress would be better addressed
through efforts aimed at encouraging sensitive and empathic parenting, at building
childhood self-esteem, at fostering sound interpersonal relationships, and at promoting
involvement and commitment to meaningful goals. Such interventions may not have the
popular appeal of programs that appear to tackle the drug problem "directly,"
but may have greater individual and societal payoff in the end.

Forfending Misinterpretation

The finding that experimenters are the psychologically healthiest adolescents, and
the observation that some drug experimentation, in and of itself, does not seem to be
psychologically destructive, may sit badly with some. In particular, it may sit badly with
drug counselors who "know" from clinical experience that there is no level of
drug use that is safe, that it is dangerous to suggest otherwise, and that the most
effective intervention is one aiming at total abstinence. To avoid any misunderstanding,
we wish to make clear that there is no contradiction between this therapeutic perspective
and the findings we have reported. On the contrary, we are in agreement with the
therapeutic perspective.

The present data indicate that in a nonselected late adolescent sample, occasional
experimentation with marijuana is not personally or societally destructive. This view is
supported by longitudinal studies of the consequences of drug use (as well as by the
present study of the antecedents and concomitants of drug use; see, e.g., Kandel et al.,
1986; Newcomb & Bentler, 1988), and by the fact that the majority of adolescents in the
United States have experimented with marijuana but have not subsequently become drug
abusers. The apparent contradiction between clinical wisdom, on the one hand, and the
present findings, on the other, is resolved when it is recognized that individuals who
present themselves for drug treatment are not representative of the general
population of adolescents, but instead constitute a special, highly selected
subpopulation. The psychological meaning of drug use is very different for this fractional
group existing within the larger population of adolescents. For them, experimentation with
drugs is highly destructive because drugs easily become part of a broader pathological
syndrome. For adolescents more generally, some drug experimentation apparently does not
have psychologically catastrophic implications.

In closing, one final clarification is in order. In presenting research on a topic as
emotionally charged as drug use, there is always the danger that findings may be
misinterpreted or misrepresented. Specifically, we are concerned that some segments of the
popular media may misrepresent our findings as indicating that drug use might somehow
improve an adolescent's psychological health. Although the incorrectness of such an
interpretation should be obvious to anyone who has actually read this article, our concern
about media misrepresentation requires us to state categorically that our findings do not
support such a view, nor should anything we have said remotely encourage such an
interpretation.

Johnston, L. D., O'Malley, P. M., & Bachman, J. G. (1986). Drug use among
American high school students, college students, and other young adults: National trends
through 1985. Rockville, MD: National Institute on Drug Abuse.